Provider Demographics
NPI:1326731019
Name:FUNK COUNSELING SERVICES, PLLC
Entity Type:Organization
Organization Name:FUNK COUNSELING SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:AUDRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:FUNK
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:469-391-0210
Mailing Address - Street 1:101 S. FANNIN ST.
Mailing Address - Street 2:STE 112
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087
Mailing Address - Country:US
Mailing Address - Phone:469-391-0210
Mailing Address - Fax:
Practice Address - Street 1:101 S. FANNIN ST.
Practice Address - Street 2:STE 112
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087
Practice Address - Country:US
Practice Address - Phone:469-391-0210
Practice Address - Fax:469-391-0210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty